RESUMEN
A 76-year-old patient presents multiple comorbidities and gastrointestinal symptoms. The upper gastrointestinal endoscopy exam reveals distal stiffness esophageal mucosa. A biopsy was taking creating sloughing of 20 mm long by 6 mm wide with self-limited bleeding. Specimen is compatible with Esophagitis Dissecans Superficialis (EDS). This is a rare entity first described in 1800, characterized endoscopically by mucosal detachment in vertical strips like "gift paper tape", which is confirmed by pathology with a mucosa with "two tones", composed of a eosinophilic superficial layer and a normal-appearing basophilic area. It may be accompanied by minimal focal inflammation. The etiopathogenesis is not clear; however, it has a good response to proton pump inhibitors (PPIs). In our case, the patient presented all the characteristics of EDS, and given its low reported frequency, a review of the literature and discussion of this rare entity was performed.
Asunto(s)
Esofagitis , Humanos , Anciano , Esofagitis/etiología , Esofagoscopía/efectos adversos , Mucosa Esofágica , Biopsia/efectos adversos , Inhibidores de la Bomba de Protones/uso terapéuticoRESUMEN
Paciente de 76 años con múltiples comorbilidades presenta sintomatología gastrointestinal, donde la endoscopía digestiva alta revela mucosa esofágica "acartonada" en tercio distal, que a la toma de biopsia se produce esfacelación de 20 mm de largo por 6 mm de ancho, con sangrado que se autolimita. Muestra patológica es compatible con Esofagitis Disecante Superficial (EDS). Esta es una entidad poco frecuente descrita por primera vez en 1800, caracterizada endoscópicamente por desprendimiento de mucosa en tiras verticales como "cinta de papel de regalo", que se confirma mediante patología con una mucosa "bitonal", compuesta por una capa superficial eosinofílica y una zona basofílica de apariencia normal. Puede estar acompañada de inflamación mínima focal. La etiopatogenia no es clara; sin embargo, tiene buena respuesta a inhibidores de bomba de protones (IBPs). En nuestro caso la paciente presentaba todas las características de EDS, y ante su baja frecuencia reportada, se realizó revisión de literatura y discusión de esta rara entidad.
A 76-year-old patient presents multiple comorbidities and gastrointestinal symptoms. The upper gastrointestinal endoscopy exam reveals distal stiffness esophageal mucosa. A biopsy was taking creating sloughing of 20 mm long by 6 mm wide with self-limited bleeding. Specimen is compatible with Esophagitis Dissecans Superficialis (EDS). This is a rare entity first described in 1800, characterized endoscopically by mucosal detachment in vertical strips like "gift paper tape", which is confirmed by pathology with a mucosa with "two tones", composed of a eosinophilic superficial layer and a normal-appearing basophilic area. It may be accompanied by minimal focal inflammation. The etiopathogenesis is not clear; however, it has a good response to proton pump inhibitors (PPIs). In our case, the patient presented all the characteristics of EDS, and given its low reported frequency, a review of the literature and discussion of this rare entity was performed.